What is carpal tunnel syndrome and the role of the median nerve:
The carpal tunnel is an anatomical canal located on the inside of the wrist, through which the flexor tendons of the fingers and the median nerve pass.The median nerve plays a fundamental role in the sensory and motor function of the hand: it provides sensitivity to the thumb, index finger, middle finger and half of the ring finger. It controls most of the muscles responsible for fine movements and precision grip of the thumb and allows for coordinated movements and fine tactile sensitivity, which are essential for everyday activities. Carpal tunnel syndrome refers to compression of the median nerve, which can occur due to an increase in the volume of the structures (inflamed tendons) or a reduction in the space of the carpal tunnel.
What are the causes and risk factors?
The exact cause of carpal tunnel syndrome is not fully understood; however,several risk factors have been identified that promote its onset. These include pregnancy, diabetes mellitus, hypothyroidism, certain forms of amyloidosis andrheumatoid arthritis. Additional predisposing conditions include repetitive or prolonged movements of the wrist in extension (e.g. when using hand tools such as a screwdriver), incorrect posture when using a computer keyboard, and prolonged exposure to vibrations generated by electrical or mechanical tools.
What are the most common symptoms?
Symptoms develop gradually and include changes in sensitivity with numbness and tingling affecting the first three fingers and the radial half of the fourth finger. These are often accompanied by pain in the hand that can radiate to the forearm and a reduction in muscle strength.
Occupational therapy treatment:
-Creation of wrist braces to be worn at night to maintain a neutral position and limit compression of the carpal tunnel, resulting in a reduction in symptoms;
-Specific mobilisation and exercises aimed at promoting the sliding of the tendons and median nerve, as well as stretching and muscle strengthening exercises to preserve hand mobility and strength;
-Pain management using instrumental techniques (e.g. Tecar therapy) and soft tissue manipulation to relieve pain and tension;
-Aids and environmental adaptations that promote correct posture and avoid overloading the affected structures during daily activities;
-Ergonomic education, through the correction of incorrect posture and modification of the working environment to reduce pressure on the wrist;
-Treatment of associated conditions, if present, in collaboration with other healthcare professionals, to optimise the overall effectiveness of the therapeutic programme.
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